Individual provider Active NPI

Amy Marie Raynes, M.D.

  • Pediatrics Physician
  • Frederick, MD
National Provider Identifier
1063673853
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
PENDING Issued in MD
Practice address
400 W Seventh St
Frederick, MD 21701-4506
Phone
(240) 566-3251
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PENDING MD Primary

Addresses

Primary practice location

400 W Seventh St
Frederick, MD 21701-4506

Mailing address

204 Lee St
Apartment # 511
Gaithersburg, MD 20877-2947
Phone (517) 230-6798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000530 MD Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4385813138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PENDINGMDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Maryland-Frederick PC CurrentSince Feb 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

Interoperability endpoints

  • Direct secure messaging: amy.raynes@pmuc.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1063673853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 LEE ST",
            "address_2": "APARTMENT # 511",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772947",
            "telephone_number": "517-230-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W SEVENTH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNES",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.